ABSTRACT
Adolescents with ADHD engage in more risk-taking behaviour than adolescents without ADHD. Mind-wandering is an underlying process of ADHD and a potential underlying process of risk-taking behaviour in ADHD. The aim of this study was to test if mind-wandering predicted risk-taking behaviour above and beyond ADHD symptoms. 315 adolescents (age: M = 17.2, range = 16 – 22) participated in this study, and filled in a questionnaire about mind-wandering, ADHD symptoms, and risk-taking behaviour. The results show that ADHD symptoms predict risk-taking behaviour, and a combination of ADHD symptoms and mind-wandering predict risk-taking behaviour. However, mind-wandering does not predict risk-taking behaviour above and beyond ADHD symptoms. These findings suggest that mind-wandering is not the underlying process of risk-taking behaviour in ADHD. In clinical practice, there should be a focus on risk-taking behaviour in ADHD. Further research should focus on the different characteristics of ADHD as a predictor for risk-taking behaviour.
Introduction
Attention Deficit and Hyperactivity Disorder (ADHD) is a well-known mental disorder and represents a concern for mental health (Kupfer, 2000). In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), ADHD is presented as a neurobiological developmental disorder. This disorder is characterised by a persistent pattern of inattention, hyperactivity, and impulsivity, significantly obstructing daily functioning and development (American Psychiatric Association, 2013). Besides these general ADHD symptoms, it is widely acknowledged that other problems, such as risk-taking behaviour, can be associated with ADHD (Mohr-Jensen & Steinhausen, 2016).
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Different types of risk-taking behaviour are more commonly seen among individuals with ADHD than those without. In daily life, for example, they engage more frequently in risky sexual behaviour (Flory, Molina, Pelham, Gnagy, & Smith, 2010), substance abuse (Steve S. Lee, Humphreys, Flory, Liu, & Glass, 2011), and gambling (Dai, Harrow, Song, Rucklidge, & Grace, 2016), and commit offenses more often than people without ADHD (Mohr-Jensen & Steinhausen, 2016). These aforementioned types of risk-taking behaviour can have effects on various levels, both societal and individual.
The effects of risk-taking behaviour, occurring at both the societal and individual levels, are predominantly destructive. For instance, individuals who engage in this behaviour are more likely to be involved in car accidents (Jonah, 1986). Additionally, the leading cause of death among adolescents is risk-taking behaviour (Dahl, 2004). Both car accidents and higher death rates result in increased healthcare costs and can greatly impact the individual and their family (Harpin, 2005). An individual with ADHD incurs higher healthcare costs (Hakkaart-van Roijen et al., 2007), and is more often expelled from school or dismissed from their job (Harpin, 2005). All these effects can be triggered by risk-taking behaviour (Dahl, 2004). Sadly, the reason why individuals with ADHD engage in more risk-taking behaviour than those without is not clear. However, one possible explanation could be the chronic low arousal experienced by individuals with ADHD, potentially associated with risk-taking behaviour. When an individual experiences chronic low arousal, they commonly have problems with attention control (Matthies, Philipsen, & Svaldi, 2012). This issue may be related to an underlying mental process of ADHD.
Mind-wandering is associated with functional problems and is linked to psychopathologies like ADHD (Franklin et al., 2014). In addition, mind-wandering is an evident underlying mental process of ADHD (Mowlem et al., 2016). The thoughts of people in the general population are unrelated to their environment or current activities 24 to 50 percent of the time (Kane et al., 2016; Killingsworth & Gilbert, 2010). When these unrelated thoughts are deliberate, there is no problem. However, the problem arises when the mind-wandering is spontaneous (Smallwood & Schooler, 2015). Mowlem et al. (2016) studied the prediction of risk-taking behaviour through mind-wandering. 108 participants filled in self-report questionnaires, concerning ADHD symptoms, mind-wandering, and impairment. Risk-taking behaviour was covered in a part of the impairment questionnaire. They found that mind-wandering is an independent predictor for risk-taking behaviour. Mind-wandering may be the underlying process which links risk-taking behaviour and ADHD.
Mind-wandering can cause difficulties for someone to focus on a relevant task or event, which can make it more difficult to ensure good performance. Because someone’s thoughts are constantly ‘on the go’, it can be difficult to think through and plan activities. When this happens, possible risks may be overlooked. Furthermore, it is possible that people who engage in a lot of mind-wandering due to chronically low arousal seek distraction to reduce this problem. Risk-taking behaviour can be seen as highly salient activities, which result in an increase of arousal. When the arousal is experienced, the excessive mind-wandering will reduce, leading to a sense of relief (Mowlem et al., 2016). Although Mowlem et al. (2016) show that mind-wandering can predict risk-taking behaviour, there needs to be more evidence to show to what extent mind-wandering can predict risk-taking behaviour.
In this study, we investigate whether mind-wandering can predict risk-taking behaviour beyond ADHD symptoms. Most research on this topic focuses on adults (Franklin et al., 2014; Jonkman, Markus, Franklin, & Van Dalfsen, 2017; Mowlem et al., 2016; Seli, Smallwood, Cheyne, & Smilek, 2015). However, this research focuses on adolescents, as they engage in riskier decision-making than adults (Defoe, Dubas, Figner, & Van Aken, 2015). All the participants will fill out self-report questionnaires about ADHD symptoms, mind-wandering, and risk-taking behaviour. Firstly, we will check whether ADHD symptoms predict risk-taking behaviour. Secondly, we will check if mind-wandering can predict risk-taking behaviour beyond ADHD symptoms.
We expect that mind-wandering can predict risk-taking behaviour beyond ADHD symptoms. Additionally, we expect a positive prediction of risk-taking behaviour through ADHD symptoms. Furthermore, we expect mind-wandering to predict risk-taking behaviour beyond ADHD symptoms.
Method
Participants
A total of 315 adolescents participated in this study, their ages ranged from 16 to 22 with an average age of 17.2 (SD = 1.3). Among them, 104 were male, 205 were female, one identified as gender-neutral and six did not wish to disclose this information. A total of 49 participants disclosed being diagnosed with AD(H)D and 19 were on AD(H)D medication. The participants were recruited from public high schools and secondary vocational schools, known in Dutch as Middelbaar Beroepsonderwijs. There was no reward offered for participation in the study. All participants signed an informed consent form and were given the option to withdraw from participating in the questionnaire at any given time.
Materials
The ADHD self-report questionnaire (Kooij & Buitelaar, 1997) was used to identify ADHD symptoms. Participants were asked if they felt restless and if they were easily distracted, among other things. The questionnaire included 23 items, as five symptoms were reformulated into two items. All items were scored on a four-point Likert scale (0 never or rarely to 3 very often) (cf. Kooij, Boonstra, Swinkels, Bekker, de Noord, & Buitelaar, 2008). The scores were totaled for analysis, with the maximum score being 69.
The risk-taking behaviour self-report questionnaire was used to gauge participants’ propensity to engage in risky behaviour, such as drinking alcohol and engaging in unsafe sex. This questionnaire consisted of 28 items on a five-point Likert scale (0 never to 4 weekly). The scores were added together to create a total, with the maximum score being 112. This questionnaire was based on previously established surveys (Figner & Weber, 2011; Pat-Horenczyk et al., 2007; Pollak, Poni, Gershy, & Aran, 2017).
The Mind Excessively Wandering Scale (MEWS) (Mowlem et al., 2016) was utilized to monitor mind-wandering. Participants were asked if they had difficulty controlling their thoughts or switching off their thoughts. The MEWS consisted of 12 items on a four-point Likert scale (0 never or rarely to 3 almost always or constantly). The points were combined for the analysis with the maximum score being 36. This questionnaire was translated from English to Dutch.
In addition to the questionnaires, participants were asked to answer some demographic questions regarding their age, sex, diagnosis, and medication use.
Procedure
During school hours, the participants filled in the questionnaires in place of their regular curriculum. As this study is part of a larger research project, participants filled in four additional questionnaires. The complete questionnaire process took approximately 15 to 25 minutes. Participants were requested to answer all questions completely. Where laptops or computers were available, online questionnaires were utilized via the Qualtrics website. Those without access completed the questionnaire in a paper booklet. During the questionnaire session, participants were not permitted to speak with one another or use their cell phones.
Analyses
The data were analyzed using multiple regression blockwise entry. In the initial block, ADHD symptoms were classed as the independent variable and risk-taking behaviour was deemed the dependent variable. The second block used risk-taking behaviour as the dependent variable, and mind-wandering along with ADHD symptoms as the independent variables.
The following assumptions will be checked: (1) the independent variable is continuous; (2) the sample is random; (3) the independent variable has variance; (4) multicollinearity; (5) correlations outside the model; (6) homoscedasticity; (7) uncorrelated residues; (8) normally distributed; (9) independent participants; (10) linearity. Possible outliers will be detected using the MAD method (Leys, Ley, Klein, Bernard, & Licata, 2013), using the moderately conservative version of 2.5. When outliers are detected, the analysis will be run with and without outliers, and both will be reported. If less than 25% of the items of a questionnaire are missing, the data will be included; the total score will be imputed by the mean score of the filled-in items of that participant on that questionnaire. If the participant completed less than 25% of the questionnaire, the data on that questionnaire of that participant will be discarded.
Results
One participant did not complete the ADHD and risk-taking behaviour questionnaire, and two participants did not complete the risk-taking behaviour questionnaire. These three participants are not included in the data analysis. The Median Absolute Deviation (MAD) method was used to detect outliers (Leys et al., 2013). Since there were no outliers according to the MAD method, no participants needed to be excluded in the further analysis. Table 1 presents the mean, median, standard deviation (SD), and range of ADHD, mind-wandering, and risk-taking behaviour.
A block-wise multiple regression analysis was used to test if mind-wandering predicts risk-taking behaviour above and beyond ADHD symptoms. The assumptions of multicollinearity and homoscedasticity were violated. Because the mind-wandering and ADHD questionnaire have a strong linear relationship, shown in Table 2, the assumption of multicollinearity is violated. Typically, one of the independent variables will be excluded in the analysis, but because the main question is based on the prediction of both variables, they are both included in the analysis. Despite violating the homoscedasticity assumption, we did not use a non-parametric alternative because we are interested only in parameter estimation, not significance testing (Field, 2013).
The first regression tested whether ADHD symptoms significantly predict risk-taking behaviour. The regression indicates that ADHD symptoms are a significant predictor of risk-taking behaviour, F(1,310) = 79.87, p .001 >.001
Mind-wandering >.001 . >.001
Risk taking behaviour >.001 >.001 .
Discussion:
In this study, we investigated the prediction of risk-taking behaviour. The primary question was whether mind-wandering predicts risk-taking behaviour above and beyond ADHD symptoms. We conducted this study through self-report questionnaires in adolescents. However, this study did not detect any evidence that mind-wandering predicts risk-taking behaviour above and beyond ADHD symptoms. Nevertheless, the results do show that ADHD symptoms predict risk-taking behaviour.
These results are not in line with the data obtained in the study of Mowlem et al. (2016). They suggested that mind-wandering could be used to predict risk-taking behaviour instead of ADHD. However, they based the degree of risk-taking behaviour on an impairment questionnaire, which may have resulted in a limited presentation of risk-taking behaviour. Risk-taking behaviour is possibly better operationalized in this study than in the study of Mowlem et al. (2016). Mind-wandering may predict those limited parts of risk-taking behaviour above and beyond ADHD symptoms. However, when all aspects of risk-taking behaviour are taken into account, mind-wandering does not predict risk-taking behaviour above and beyond ADHD symptoms. This different operationalisation of risk-taking behaviour may explain the divergent results.
All the questionnaires used in this study are self-report questionnaires, which can be a limitation. Adolescents have a tendency to report more or less than the reality due to selective memory, attribution or exaggeration. The deviant answers can vary for each question (Brener, Billy, & Grady, 2003). In other words, an adolescent may report more problems than he actually experiences on the first question, fewer problems on the second question and quite accurately on the third question, which could result in an inaccurate representation of the ADHD symptoms, degree of mind-wandering or degree of risk-taking behaviour and lead to an inaccurate conclusion. A second limitation in this study is that there exists a strong linear relationship between the mind-wandering and ADHD questionnaires. It is possible that they both measure roughly the same problems, but the ADHD questionnaire is more widespread. When the ADHD questionnaire is more widespread, it may contain more aspects crucial for the prediction of risk-taking behaviour than the mind-wandering questionnaire. Therefore, mind-wandering may miss important aspects for the prediction of risk-taking behaviour.
Furthermore, besides the role of mind-wandering as an underlying process, it overlaps with regular ADHD symptoms. The main characteristics of ADHD are inattention, hyperactivity, and impulsivity. Mind-wandering is strongly related to the inattention part of ADHD. So maybe it is not the inattention part of ADHD that can predict mind-wandering, but one of the other characteristics. In the study of Lee & Hinshaw (2006), they found that inattention symptoms could not predict risk-taking behavior. This is in contrast to hyperactivity and impulsivity symptoms, which could predict risk-taking behavior. An explorative analysis was run to check if this is the same case with our data.
There are several implications for both clinical practice and further research based on the results of the current study. Regarding clinical practice, when an individual is diagnosed with ADHD, clinicians should always keep risk-taking behavior in mind as a potential threat. In terms of further research, the operationalisation could be objectified. For example, instead of a self-report questionnaire of risk-taking behavior, the participants could keep score of certain behavior for a period of time. Furthermore, research could focus on the different characteristics of ADHD in combination with risk-taking behavior. Once it is more clear which characteristics – inattentiveness, hyperactivity, or impulsivity – can best predict risk-taking behavior, prevention of this behavior can be focused on.
Overall, this study shows an evident link between ADHD and risk-taking behavior. However, there is no evidence for mind-wandering as an underlying process for this problem. In clinical practice, it is crucial to directly assess risk-taking behavior when ADHD is diagnosed.
The Effect Of The Enlightenment On The World Today
How could, a simple thing like tea, or stamps lead to a Revolution? The American Revolution was a political rebellion in which the American colonists overthrew their Britain, their Motherland due to a series of violations to their rights. The revolution took place all across America, from 1775 to 1783. The two sides of the revolution were the British and the American colonists, who were often known as the Patriots.
The American Revolution was sparked by the Stamp and Sugar Acts, the Boston Tea Party and finally, the Enlightenment idea of Social Contract. Firstly, the Stamp and Sugar Acts was one of the reasons the American Revolution occurred. Following the Seven Years of war, Britain was dramatically indebted. It had left Britain with a national debt of more than 140 million pounds. They also felt that because the French had succeeded the people in the colonies could not be kept in control. So they issued the Proclamation of 1763, which was a decree which prohibited colonists from settling anywhere further west than the Appalachians.
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The colonists thought the restrictions were unfair and mostly ignored them. However, in order for Britain to increase their number of troops stationed along the new frontier, they needed to pay around 320,00 pounds a year. To get this money and to help repay their national debt, they inflicted the Sugar Act, which required citizens of colonies to pay taxes on sugar, a popular good. They also imposed the Stamp Act, which required all legal documents and things such as cards in the colonies to have a tax stamp. These restrictions raged people in colonies. A group was formed of people who strongly didn’t agree with the restrictions Britain was putting on them, they called themselves the Patriots. The passing of these acts resulted in a great deal of protest in the colonies. People called them, “unconstitutional and “without precedent and they were very upset that the acts had been passed without giving them a say. They protested by boycotting British taxed goods, which was very effective. The boycott inspired British business leaders to petition the acts, pointing out that the acts not only made colonists refuse to import British goods, but also made them unable to pay back nearly five million pounds they owed British suppliers.
Next, it made Pitt, make a statement suggesting repealing the acts. These statements helped to motivate the government to repeal the act. The other way that colonists protested these acts was by violently destroying the home of the collecting taxes agent, Andrew Oliver and attacking many tax collectors and supporters of the British. The seeds of anger these Acts planted was only the beginning of what would later be a Revolution. Clearly, the passing of them had a great effect on the people in the colonies, and therefore it proves that these Acts were one of the main reasons the Revolution transpired. Secondly, the Boston Tea Party helped spark the American Revolution. In the 1770s one of the most valuable goods in the Western world was tea, as it was new and thought to be easy to sell. However, by 1773, a lack of sales left the British East India Company with a surplus of tea of over 17 million pounds, left in warehouses rotting. The British East India Company sought a solution, finally turning to the American colonies.
Usually, British Tea merchants sold to American traders in London at a markup, who would then sell to the American colonies. However, the British Government decided, to remove the ‘middle man’ which was the American merchants, and just directly ship the tea over to America at a lower cost. The British figured that the Tea Act would result in making the colonial people happy because they could purchase less expensive tea, however, the Patriots saw the act as unfair, believing it gave an unfair advantage to the British East Indian Company making it unfair to the American colonial merchants. A few years before this change had been made, however, the British passed the Townshend Duties which were new taxes the British government put on the colonies for the import of; glass, lead, paint, paper, and tea. These acts received major backlash ending in them all being repealed other than the tax on tea.
This also angered the colonists and helped lead to what is now known as the Boston Tea Party. On December 16th, 1773, between 6 p.m and 9 p.m it is documented that over 116 colonists dressed up as Mohawk Indians. boarded a ship filled with tea, in Boston Harbor and threw 342 chests of tea overboard to protest the unfair acts and taxes being placed on them. It is estimated that the crates of tea thrown into the water cost over 10,000 pounds. This act of defiance to the British was certainly a turning point that helped lead to the Revolution. It not only raged the British, causing them to double down and place stricter Acts but it also brought support from the colonies to the Patriots, encouraging each sides anger increase.
In conclusion, the Boston Tea Party was a crucial factor that led and caused the American Revolution. Thirdly, Enlightenment ideas helped cause the Revolution. At the beginning of the 18th century, the Enlightenment began and towards the end of the 18th century, the American Revolution occurred. Due to their overlapping time periods and similar issues, the American Revolution was filled with references to the Enlightenment. A year after the American Revolution, on July 4, 1776, the Declaration of Independence was finalized. The Declaration of Independence was a document which in short, liberated America from their loyalties to and connection with Britain. The Declaration of Independence stated that all people are born equal, and for that, they deserve standard rights.
Among these basic rights, they have the right to life and freedom and the right to seek happiness in the way they choose. It then states that, in order for these rights to be protected, governments are set into place, and that governments get their power from their people. Next, it stated that if people believe their rights are not being protected, they can organize their own government, in a way that does protect these rights. This idea, that the government should protect the rights of their people and if not people should be able to revolt is an idea which was very popular during the Enlightenment and was and is still, known as ‘Social Contract.’ The idea was introduced by John Locke but was elaborated on by many, famously including Jean-Jaques Rosseau.
In fact, Rousseau’s, most famous piece of writing was called, “The Social Contract and was published in 1762, only 14 years apart from when the Declaration of Independence was published. This shows the likelihood that the Declaration of Independence was partly inspired by the Enlightenment idea of Social Contract. The whole reason the American colonists liberated themselves from Britain was that the British were violated their rights, therefore, their Social Contracts. To conclude, as shown in the Declaration of Independence, the American Revolution was partly sparked by the Enlightenment idea of Social Contract.
In conclusion, the leading factors of what caused the American Revolution are Stamp and Sugar Acts, the Boston Tea Party and finally, the Enlightenment idea of Social Contract. However, it is important to understand that the American Revolution did not occur in one night, however, it was a build up of anger and tension between the British and the American colonists. It can still be said, however, that the Stamp and Sugar Acts, were what helped begin the colonist’s anger, the Boston Tea Party was an action to their anger, and the Enlightenment idea of Social Contract inspired their anger. So finally, all in all, it can be argued that Stamp and Sugar Acts, the Boston Tea Party and, the Enlightenment idea of Social Contract were all factors of what eventually sparked the American Revolution.
